Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery.

Abstract

PURPOSE:

To clarify the effect of systemic dexamethasone (DXM) on pain and postoperative opioid (oxycodone) consumption after blowout fracture surgery.

MATERIALS AND METHODS:

A prospective randomized observer-blinded trial of 20 patients who had a blowout fracture requiring surgical intervention was conducted. Patients were randomly assigned to receive a total dose of intravenous DXM 30 mg perioperatively or no DXM (controls). Pain was assessed postoperatively using a 10-cm visual analog scale (VAS) each time analgesics (acetaminophen every 6 hours or oxycodone upon request) were administered. The VAS area under the curve (VAS AUC) for 24 hours postoperatively represented the outcome. Data were analyzed using χ2 test, Student t test, 2-tailed Mann-Whitney U test, and linear regression, with a P value less than .05 indicating significance.

RESULTS:

Patients with blowout fracture receiving perioperative systemic DXM exhibited a significantly lower average VAS AUC (P = .04). After controlling for other confounding variables, this result remained significant (P = .03).

CONCLUSIONS:

DXM appears to decrease postoperative pain and thus is recommended as a pre-emptive analgesic in blowout fracture surgery.

• Authors: Eeva Kormi, Johanna Snäll, Anna-Maria Koivusalo, Anna Liisa Suominen, Hanna Thorén, Jyrki Törnwall
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 75 Issue 6 Pg. 1232-1237 (Jun 2017) ISSN: 1531-5053 [Electronic] United States
• PMID: 27770628 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2017. Published by Elsevier Inc.

Chemical References

• Analgesics, Opioid
• Anti-Inflammatory Agents
• Acetaminophen
• Dexamethasone
• Oxycodone

Topics

• Acetaminophen (therapeutic use)
• Adult
• Aged
• Analgesics, Opioid (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Dexamethasone (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Orbital Fractures (surgery)
• Oxycodone (therapeutic use)
• Pain Measurement
• Pain, Postoperative (drug therapy)
• Prospective Studies